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New research will help diabetics exercise more safely

News, 09 March 2015

Reducing insulin dosage can help diabetics avoid blood sugar dips at night after exercising in the evening, a new study from Northumbria University has found.

Funded by Diabetes UK and the Northumbria University Strategic Investment Fund, it is the first ever study which has found a way to completely avoid these dangerous falls in blood glucose – hypoglycemia – that occur after exercise.

Anyone can experience hypoglycemia, but diabetics are particularly vulnerable. This is because exercise alters the body’s sensitivity to insulin and accelerates its effect. When this happens to a diabetic person, their blood sugar is used up too quickly which means it can rapidly drop hours after exercising – particularly during the night when it is most dangerous.

Dr Dan West, a Senior Lecturer in Sport, Exercise and Rehabilitation, and his PhD student Matthew Campbell who is now a Senior Research Associate in the department, set out to test whether altering diet and insulin doses could help to prevent this potentially life-threatening problem. Dr West said: “For diabetes sufferers, the fear of experiencing a dangerous blood sugar dip after exercise can prevent them from exercising altogether – which has both physical and psychological implications. We have developed a strategy to manage insulin dosage in a way that prevents these falls in blood sugar so that diabetics can exercise safely.”

Their two-part study, which was carried out at the Royal Victoria Infirmary’s National Institute Health Research (NIHR) Clinical Research Facility in Newcastle in collaboration with Professors Mark Walker and James Shaw looked at the effects of adjusting slow-acting insulin levels in a group of 10 male participants with Type-1 Diabetes. Blood sugar levels were monitored using a continuous glucose monitor which sits underneath the skin and has an alarm which is trigged if levels begin to fall dangerously.

In the first test, all participants took a normal slow-acting insulin dose and then completed a 45 minute exercise session at 6pm in the evening. Around 7-8 hours after the exercise, 90% of the patients experienced a blood sugar dip, all of which occurred whilst they were sleeping. During the second test, the insulin dose was reduced by 20% and participants took part in the same evening exercise session. This time, however, none of the participants suffered from drops in blood sugar.

Unexpectedly, the study also found that the 20% reduction of insulin not only prevented blood sugar from falling but also stopped glucose levels from rising too high. With this dose, levels remained within the ideal healthy range, and other important markers such as ketones and inflammatory cytokines were not affected. This is particularly important finding as clinicians are often reluctant to change treatment regimens because of potentially exposing patients to these consequences.

The research has been shortlisted for the Lilly Diabetes Clinical Science Poster Award at the 2015 Diabetes UK conference this week. The prize money would be used to help further this research and move towards incorporating the findings into clinical practice. The researchers now intend to look at the education of patients who want to exercise and research the impact this could have on people’s lifestyles.